| NPI | 1619930260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CA A55472) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A55472) |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2022-10-19 |